Active NPI
Barry Stuart Wilder, DDS
- Dentist
- Selden, NY
National Provider Identifier
1427049212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 030059
- Practice address
- 805 Middle Country Rd
Selden, NY 11784-2504 - Phone
- (631) 732-0233
- Fax
- (631) 732-0247
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 030059 | NY | Primary |
Addresses
Primary practice location
805 Middle Country Rd
Selden, NY 11784-2504
Mailing address
805 Middle Country Rd
Selden, NY 11784-2504
Phone (631) 732-0233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0065Z759 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exceldent Dental of Brookhaven LLP | Past | Accepting new patients | |
| Norman Gross DDS Barry Wilder DDS PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Selden, NY
- NPI 1730329392
-
- General Practice Dentistry
- Selden, NY
- NPI 1518139450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207008000000",
"number": "1427049212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 MIDDLE COUNTRY RD",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842504",
"telephone_number": "631-732-0233",
"fax_number": "631-732-0247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 MIDDLE COUNTRY RD",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842504",
"telephone_number": "631-732-0233",
"fax_number": "631-732-0247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDER",
"first_name": "BARRY",
"middle_name": "STUART",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2008-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "030059",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0065Z759",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Selden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.